Skip to main content
Log in

Persistent swallowing and voice problems after anterior cervical discectomy and fusion with allograft and plating: a 5- to 11-year follow-up study

  • Original Article
  • Published:
European Spine Journal Aims and scope Submit manuscript

Abstract

Anterior cervical discectomy and fusion is commonly performed for cervical disc disease. Most studies report that swallowing and voice problems after such surgeries tend to resolve with time and are often of minor significance except in the rare cases of recurrent laryngeal nerve palsies. A retrospective review was performed on patients who had anterior cervical discectomy and fusion by a single surgeon more than 5 years prior, to determine the persistence of swallowing and voice problems in them.Seventy-four patients who had anterior cervical discectomy and fusion with allograft and plating an average of 7.2 years prior responded to an invitation to return for a follow-up clinical review. Emphasis was placed on the symptoms of dysphagia and dysphonia, as related to the index surgery. At final review, persistent dysphagia was present in 26 patients (35.1%). This occurred more frequently in females and in younger patients. Dysphonia at final review persisted in 14 patients (18.9%). This also occurred more commonly in females and in patients in whom possible non-union is present in at least one of the levels operated upon. Problems with singing were present in 16 patients (21.6%) postoperatively, occurring more frequently if the C3/4 disc was included in the surgery and in patients who have had a greater total number of anterior cervical surgeries at the time of review. Dysphonia and dysphagia are persistent problems in a significant proportion of patients, even beyond 5 years after anterior cervical spine surgery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Apfelbaum RI, Kriskovich MD, Haller JR (2000) On the incidence, cause and prevention of recurrent laryngeal nerve palsies during anterior cervical spine surgery. Spine 25:2906–2912

    Article  CAS  PubMed  Google Scholar 

  • Bazaz R, Lee MJ, Yoo JU (2002) Incidence of dysphagia after anterior cervical spine surgery. A prospective study. Spine 27(22):2453–2458

    Article  PubMed  Google Scholar 

  • Buchholz DW, Ravich WJ (1993) Dysphagia following anterior cervical fusion. Dysphagia (abstract) 8:390

    Google Scholar 

  • Bulger RF, Rejowski JE, Beatty RA (1985) Vocal cord paralysis associated with anterior cervical fusion: considerations for prevention and treatment. J Neurosurg 62:657–661

    Google Scholar 

  • Cloward RB (1958) The anterior approach for removal of ruptured cervical disks. J Neurosurg 15:602–617

    CAS  PubMed  Google Scholar 

  • Cloward RB (1962) New method of diagnosis and treatment of cervical disc disease. Clin Neurosurg 8:93–132

    Google Scholar 

  • Connolly E, Seymour R, Adams J (1965) Clinical evaluation of anterior cervical fusion for degenerative cervical disc disease. J Neurol 23:431–437

    Google Scholar 

  • Daniels SK, Mahoney MC, Lyons GD (1998) Persistent dysphagia and dysphonia following cervical spine surgery. Ear Nose Throat J 77(6):470–475

    CAS  PubMed  Google Scholar 

  • Dohn DF(1966) Anterior interbody fusion for treatment of cervical-disk conditions. JAMA 197(11):897–900

    Article  Google Scholar 

  • Flynn TB (1982) Neurologic complications of anterior cervical interbody fusion. Spine 7:536–539

    Google Scholar 

  • Frempong-Boadu A, Houten JK, Osborn B, Opulencia J, Kells L, Guida DD, Le Roux PD (2002) Swallowing and speech dysfunction in patients undergoing anterior cervical discectomy and fusion: a prospective, objective preoperative and postoperative assessment. J Spinal Disord Tech 15(5):362–368

    Google Scholar 

  • Heeneman H (1973) Vocal cord paralysis following approaches to the anterior cervical spine. Laryngoscope 83:17–21

    Google Scholar 

  • Kriskovich MD, Apfelbaum RI, Haller JR (2000) Vocal fold paralysis after anterior cervical spine surgery: incidence, mechanism and prevention of injury. Laryngoscope 110:1467–1473

    Article  Google Scholar 

  • Lunsford LD, Bissonette DJ, Jannetta PJ, Sheptak PE, Zorub DS (1980) Anterior surgery for cervical disc disease. Part 1: treatment of lateral cervical disc herniation in 253 cases. J Neurosurg 53:1–11

    Google Scholar 

  • Martin RE, Neary MA, Diamant NE (1997) dysphagia following anterior cervical spine surgery. Dysphagia 12(1):2–10

    CAS  PubMed  Google Scholar 

  • Morpeth JF, Williams MF. (2000) Vocal fold paralysis after anterior cervical diskectomy and fusion. Laryngoscope 110:43–46

    Article  Google Scholar 

  • Netterville JL, Koriwchak MJ, Winkle M, Courey MS, Ossiff RH (1996) Vocal fold paralysis following anterior approach to the cervical spine. Ann Otol Rhinol Laryngol 105:85–91

    Google Scholar 

  • Riley L, Robinson R, Johnson K, Walker AE (1969) The results of anterior interbody fusion of the cervical spine: review of ninety-three consecutive cases. J Neurosurg 30:127–133

    Google Scholar 

  • Robinson RA, Smith GW (1955) Anterolateral cervical disc removal and interbody fusion for the cervical disc syndrome. Bull John Hopkins Hosp 96:223–224

    Google Scholar 

  • Robinson RA, Walker AE, Ferlic DC, Wiecking DK (1962) The results of anterior interbody fusion of the cervical spine. J Bone Joint Surg 44A:1569–1586

    Google Scholar 

  • Smith-Hammond CA, New KC, Pietrobon R, Curtin DJ, Scharver CH, Turner DA (2004) Prospective analysis of incidence and risk factors of dysphagia in spine surgery patients. Spine 29(13):1441–1446

    Article  Google Scholar 

  • Southwick WO, Robinson RA (1957) Surgical approaches to the vertebral bodies in the cervical and lumbar regions. J Bone Joint Surg 39A:631–644

    Google Scholar 

  • Tew JM, Mayfield FA (1976) Complications of surgery of the anterior cervical spine. Clin Neurosurg 23:424–434

    Google Scholar 

  • Welsh LW, Welsh JJ, Chinnici JC (1987) Dysphagia due to cervical spine surgery. Ann Otol Rhinol Laryngol 96:112–115

    CAS  PubMed  Google Scholar 

  • Winslow CP, Meyers AD (1999) Otolaryngologic complications of the anterior approach to the cervical spine. Am J Otolaryngol 20:16–27

    Article  CAS  PubMed  Google Scholar 

  • Winslow CP, Winslow TJ, Wax MK (2001) Dysphonia and dysphagia following the anterior approach to the cervical spine. Arch Otolaryngol Head Neck Surg 127:51–55

    CAS  PubMed  Google Scholar 

  • Zeidman SM, Ducker TB, Raycroft J (1997) Trends and complications in cervical spine surgery:1989–1993. J Spinal Disord 10(6):523–526

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Wai-Mun Yue.

Additional information

The study was performed at the Columbia Spine Centre, Columbia, Missouri, USA

Rights and permissions

Reprints and permissions

About this article

Cite this article

Yue, WM., Brodner, W. & Highland, T.R. Persistent swallowing and voice problems after anterior cervical discectomy and fusion with allograft and plating: a 5- to 11-year follow-up study. Eur Spine J 14, 677–682 (2005). https://doi.org/10.1007/s00586-004-0849-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00586-004-0849-3

Keywords

Navigation